Andy Packel, PT, serves as the Locomotor Coordinator at MossRehab Elkins Park and is a board-certified neurologic physical therapy specialist with over 20 years of clinical experience.
What motivated you to become a physical therapist?
When I finished my undergraduate degree in physics from Carnegie Mellon University in Pittsburgh, I wasn’t sure what to do. I had a friend in physical therapy school at the time and initially thought I would work with athletes and professional sports teams. That’s how I formulated the idea of becoming a physical therapist (PT). Before pursuing the field, I took some pre-requisite courses in physical therapy and worked in a hospital where I found I liked working with patients in their rehabilitation.
What is your educational background and training?
I earned my Master of Science in physical therapy from Boston University. As part of the program, I completed internships at facilities in San Francisco, New Orleans, Tacoma, and lastly at MossRehab in Philadelphia. When interning at MossRehab, I found my calling. I am also board certified as a neurologic specialist.
How long have you been at MossRehab? What makes you stay?
After my internship at MossRehab, I knew I wanted to work here and have remained during my entire career for nearly 25 years. MossRehab has a rich learning environment, with opportunities to interact with other clinicians and participate in programs that teach new approaches to rehabilitation. With my main interest focused on patient care, MossRehab provides the resources to take different approaches to rehabilitation to improve outcomes.
Can you tell me about your roles at MossRehab?
As a member of the PT team on the inpatient stroke unit at MossRehab Elkins Park, I treat patients with acquired brain injuries resulting from stroke or traumatic brain injury and individuals with encephalopathies (diseases to the brain). My clinical focus is on gait rehabilitation in getting my patients to walk or walk better.
As locomotor coordinator, I coordinate walking activities that may include using technologies for inpatient and outpatient gait rehabilitation to help therapists get the best results for their patients. I also help clinicians feel comfortable with the different robotics and technologies available at MossRehab. Because MossRehab has one of the largest collections of robotics in the country and probably the world, I help clinicians to choose the best device(s) to assist a patient in gait rehabilitation.
In addition, I’m involved in developing and executing different continuing education courses. Some are meant to put out new ideas, while others are created as part of our PT neurologic residency program. I also contribute to research and clinical projects related to walking rehabilitation and participate as a speaker at national conferences. Some of my presentations have focused on walking dysfunction, specification of rehabilitation treatments, and clinical reasoning in physical therapy.
What is the Rehabilitation Treatment Specification System?
The Rehabilitation Treatment Specification System (RTSS) is a framework that helps clinicians to consider and define their treatments using clinical reasoning rather than a check-list approach. Started as a joint project between MossRehab and the Icahn School of Medicine at Mount Sinai in New York, the RTSS is now advanced by a Networking Group of the American Congress of Rehabilitation Medicine (ACRM). I have been involved with the RTSS project throughout its development. The RTSS framework is increasingly being adopted worldwide to support research, rehabilitation practices, and education programs for student therapists.
What is your approach to physical therapy?
Physical therapy must be individualized towards the specific deficits or difficulties experienced by the patient. In gait rehabilitation, I first assess a patient’s walking ability to determine their difficulties before even starting any treatment. Following the RTSS framework, I develop individualized therapy strategies to address these walking deficits.
How do you use therapeutic robotics in PT?
It is largely through practice that patients improve their walking ability. If someone cannot walk by themselves or has significant difficulty, we may use technology to practice walking in the optimal way to address their deficits and maximize their ability. For example, clinicians may use the EksoNR robotic exoskeleton to support a patient with severe weakness in the lower extremities during therapy. Instead of several PTs helping the patient take several steps, the EksoNR supports an individual in taking hundreds of steps. The C-Mill VR+ is one of our newer robotics for gait and balance rehabilitation that combines a treadmill with therapy gaming. Offering greater stimulation through interactive exercises, the C-Mill can get patients to work longer and harder.
What inspires you on the job?
I'm an optimist, so I like to see good things happen to people. It inspires me when patients going through difficult challenges make progress in their rehabilitation. That’s what keeps me going.
What are your interests outside of work?
I like to challenge myself physically, so I play different sports like soccer and tennis. I also run and play Ultimate Frisbee to keep active.
What is your favorite food?
You can’t beat a good burger.
What is your life motto?
One is to work hard, play hard - that's kind of the family motto. And don't sweat the small stuff. We have plenty of big challenges today, so we got to let the small stuff go.
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